USE OF SEDATIVES IN CHILDREN 2-8 YEARS OF AGE UNDERGOING ELECTIVE SURGERIES IN GMC SRINAGAR
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Keywords
Surgery and anesthesia, midazolam, ketamine and Fentanyl, Anxiety, anxiolytics, children
Abstract
Background: Surgery and anesthesia exert an immense emotional stress on both parents and children. Behavioral and physiological measures of anxiety have identified anesthetic induction as the most stressful point during the entire preoperative period in children.
Aim: To study the use of anxiolytics in immediate preoperative/ pre-induction in children 2-8 years of age undergoing elective surgeries.
Methods: This prospective observational study was conducted in the department of Anesthesiology in Government Medical Collage Srinagar from over a period of 18 months for 120 patients of American Society of Anesthesiology physical status I-II of both sexes, aged between 2 to 8 years, scheduled for elective surgeries. Patients with cardiovascular, respiratory or neurological compromise, with known allergy to drug were excluded from the study. The study was approved by the Institutional ethics committee. Children were equally divided in to three groups Group A (n=40) oral midazolam 0.5 mg/kg (5 mg/ml parenteral formulation, Group B (n=40) oral ketamine 5.0 mg/kg (50 mg/ml parenteral formulation and Group C (n=40) oral loly pop Fentanyl (15-20mcg/kg) by random selection using random number tables between the study groups.
Results: The treatment groups were similar with respect to age, weight, sex distribution, and duration of surgery. Sedation score at 0 min (before premedication) among the study groups was statically insignificant with (p value >0.05).
The mean values of sedation score (Ramsay sedation score) at different intervals among three groups were statistically not significant with a p value of > 0.05. Anxiety score at parenteral separation between the study groups was statically insignificant with (p value >0.05). Anxiety score at intravenous cannulation between the study groups was statically insignificant with (p value >0.05). Anxiety score at mask application among the study groups the shows no statically significant differences with (p value >0.05).
Conclusion: It can be concluded from our study, that the parenteral formulation of midazolam, ketamine and Fentanyl can be safely used as premedicant in children. These oral drugs do not produce any respiratory depression in children.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Mehraj Ud Din Bhat
Senior Resident, Department of Anaesthesiology, Government Medical Anantnag, India.
Dr. Raunak Jain
Senior Resident, Department of Anaesthesiology, Pandit Madan Mohan Malviya Hospital New Delhi, India.
Dr. Divyansh Gaur
Senior Resident, Department of Anaesthesiology, Atal Bihari Vajpayee Government Medical College, Vidisha (MP), India.